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MEDICAL EDUCATION. School of Medicine Retreat February 8-10, 2002. Strategic planning group for education. Parvati Dev Charlotte Jacobs Larry Mathers Peter Schilling Gary Schoolnik Matt Scott Al Taira David Terris Dick Tsien David O’Brien. Contributors.

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medical education
MEDICAL EDUCATION

School of Medicine Retreat

February 8-10, 2002

strategic planning group for education
Strategic planning group for education

Parvati Dev

Charlotte Jacobs

Larry Mathers

Peter Schilling

Gary Schoolnik

Matt Scott

Al Taira

David Terris

Dick Tsien

David O’Brien

contributors
Contributors
  • Curriculum Reform Committee and the Faculty Senate
  • Education retreat
  • GALE developers
  • Education technologies group
  • Committee on Courses and Curriculum
  • Dean and Senior Associate Deans
  • Med Education Associate Deans
mission statement
Mission statement
  • We will educate students to become outstanding clinicians who have the skills and passion to improve the health of the world’s people through research, innovation, and leadership.
why do anything different
Why do anything different?
  • It’s not “broke”. Students do well as measured by:
    • Highly competitive admissions process
    • High pass rates on boards
    • Good reports from residency programs
    • High rate of academics (33%) 10 years after medical school
why do anything different1
Why do anything different?
  • Our education is not primed for the future
    • Too much emphasis on learning memorizing specific information
    • Not enough emphasis on:
      • Methods for accumulating and interpreting new information
      • Using the most effective educational methods--i.e., simulations, small group interactive learning, online curricula
      • Cross-disciplinary approaches to learning, particularly bridging gap between clinical and basic sciences
  • Our curriculum does not fit our faculty or our students
education program
The opportunitiesafforded students for individual innovation and cross-disciplinary work

An absence of curricular definition--what knowledge, methods and skills do students need to have?

Insufficient time devoted to fostering independent research skills and to developing clinical skills

Funds flow that neither encourages accountability nor provides incentives for teaching excellence, innovation, and interdisciplinary programs

Education program

Weaknesses

Strengths

strategic initiatives
Strategic initiatives
  • Revise the curriculum to address weaknesses and build on strengths
  • Foster and facilitate teaching, advising and mentorship
  • Develop facilities to meet future curriculum
  • Develop a community service program
strategic initiatives revise curriculum
Strategic initiatives:Revise curriculum
  • Identify core knowledge and skills required for all students
  • Develop required majors (“scholarly tracks”) for all students to enhance independent research capabilities
  • Within scholarly tracks, develop a research honors programs for a subset of students
  • Expand the clinical curriculum—particularly in the first years of medical school—to enhance pattern recognition.
  • Develop a system of incentives to promote curricular change
current curriculum
Current curriculum

Medscholars

Medscholars

TA

TA

Q1

Q2

Q3

Q4

1

Pre-clinical

2

Year

3

4

Clinical

5

proposed curricular structure
Proposed curricular structure

Undergraduate

Basic science

Molecular medicine

Clinical research

Scholarly track

Community service

Biotechnology

Clinical

Health economics

Residency and beyond

Proposed curricular structure

Year

proposal for research tracks
Proposal for research tracks
  • Interdisciplinary programs compete to create scholarly tracks including:
    • Course work for a large number of students
    • Honors program for smaller number of students based on resources, number of mentors, etc.
  • All students required to choose a track
  • A subset of students (at onset33%) can compete for the “honors” program within each track and be funded for at least a year of research with or without additional degree
  • Number of tracks can increase with time and each track can expand
  • End goal: after 5-10 years, all students will want to be in honors program or MSTP
future student body
Future student body

Honors research

Ph.D.

Med scholars

No independent scholarship.

obstacles and opportunities curriculum
Obstacles

Funds flow for education

Lack of central oversight of curriculum

Faculty may not be available to teach core elements

Facilities inadequate for variety of teaching methods

Insufficient mentorship and advising programs

Opportunities

Instructional technologies

Intersections with university campus

Graduate programs to enhance scholarly tracks

Reputation for “flexibility” in our curriculum

Chance to give Stanford a “distinctive” education

Obstacles and opportunities: Curriculum
strategic initiatives enhance teaching 1
Strategic initiatives Enhance teaching (1)
  • A certain level of teaching, advising and mentorship has to be established as a requirement for being on the faculty
  • Teaching needs to be honored, promoted and facilitated
  • The true costs of teaching courses should be established
  • Departments must consider their courses to be an essential component of their mission

Establish underlying principles

strategic initiatives enhance teaching 2
Strategic initiatives Enhance teaching (2)
  • Incentive programs for:
    • Improvement in course performance
    • Consistently high course performance
    • Revising course content
    • Developing teaching innovations, small group learning opportunities and bridges between clinical and basic science domains
    • Mentorship and advising
  • Support for pedagogy in the areas of:
    • Course content
    • How to teach and how to mentor
    • New teaching technologies
    • Course evaluation processes
obstacles and opportunities teaching
Obstacles

Tuition does not cover the true costs of teaching

Funds flow for education does not directly support teaching, mentoring or advising

Teaching, advising, and mentoring are not valued

Facilities inadequate

Opportunities

Tuition mechanisms are not fixed in stone

Faculty are interested in teaching and mentorship

Campus is big

Instructional technologies already strong

Large number of interested teachers in community

Center for Teaching and Learning and other pedagogical resources already exist

Obstacles and opportunities: Teaching
strategic initiatives1
Strategic initiatives
  • Revise the curriculum to address weaknesses and build on strengths
  • Foster and facilitate teaching
  • Develop facilities to meet future curriculum
    • Small group learning
    • Simulation spaces, virtual classrooms
    • Library
  • Develop a community service program
strategic initiatives community service
Strategic initiatives: Community service
  • The need:
    • The university, from its founding, has affirmed community service among students and graduates to be a vital component of its mission
    • There is strong interest in community service among medical and graduate students
    • There is strong interest in community service among faculty
    • The university seeks to have better community relations
    • The community (local, national and international) has enormous needs
strategic initiatives community service1
Strategic initiatives: Community service
  • Purpose of community service center
    • To provide a curriculum on service for medical and graduate students that promotes life-long commitment to action for their communities (no “amateur hour”)
    • To serve as a clearing house for service opportunities:
      • International health
      • Local health programs
      • Arbor Free Clinic and Tully Road Clinic
      • K-12 program
    • To interact with the local community
  • Possible subsidiary of the Haas Center
  • We are not a school of public health
timeline
Timeline
  • Phase I--completed by this fall
    • Establish mechanisms for reviewing curricular content
    • Identify areas for scholarly track development
    • Establish relationship with Haas Center for development of community service program
    • Establish the true costs of the education program, and develop a funding system to directly support these costs
  • Phase II--completed by fall 2003
    • Five scholarly tracks in place
    • Core knowledge and skills for basic sciences and early clinical experience established
    • Curriculum in first year adapted to core
    • Community service program in place
    • Some pedagogical programs in place to enhance teaching
    • Incentive program begun
timeline 2
Timeline (2)
  • Phase III--completed by fall 2004
    • Advising, mentoring program in place
    • Enroll first honors students, funding mechanisms in place
    • Core knowledge base for clinical education established
    • Clinical experience curriculum for second year class in place
    • Lecture-based curriculum in second year adapted to core and shrunk 20%
  • Phase IV--completed by fall 2005
    • More scholarly tracks initiated, others reviewed.
    • Basic science, scholarly track curriculum for clinical years initiated
    • Funding mechanisms solidified
    • Degree granting mechanisms in place (Masters in Medicine?)
    • Enhanced incentive program in place
    • Pedagogical evaluation of first phases of curriculum
  • Phase V
    • New building in place
balance sheet
Balance sheet
  • A new vision for medical education
  • Some components could be initiated very quickly
  • Some component can be initiated without extensive new resources
  • Some components could be costly
    • Reviewing and revising entire curriculum
    • Providing incentives for curricular improvements and teaching
    • Providing funding for honors program and graduate degrees
    • Building facilities and educational technologies
    • Developing mentorship and advising programs
  • “Trade school” or MEDICAL UNIVERSITY
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